Individual
KENNETH HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
444 N PARK BLVD, GLEN ELLYN, IL 60137-4622
(630) 469-0045
(630) 469-0645
Mailing address
444 N PARK BLVD, GLEN ELLYN, IL 60137-4622
(630) 469-0045
(630) 469-0645
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036116719
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036116719
—
IL
01
—
1033149844
ORGANIZATION NPI
—
01
—
363149833
TAX ID
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
04/30/2007
Last updated
04/04/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us